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When the Personality Disorder Wears Camouflage

WHEN a war crime doesn't look quite like a war crime — when it seems cold and deliberate like a serial murder, rather than an impulsive act of vengeance — it can be especially disturbing, as United States Army officials have learned over the past week.

According to federal prosecutors, an Army private and several comrades attacked an Iraqi family last March, raping and killing a young woman after executing her parents and her younger sister in their home. The men disguised themselves for the attack and worked as a team, the prosecutors said. Iraqi leaders are in an uproar, as are American officials in and out of the military.

The accused ringleader, Steven D. Green, 21, who was discharged in May, pleaded not guilty after his arrest June 30, and details of the crime were still emerging last week. The Army has said it discharged Mr. Green for a "personality disorder."

Which raises a question: How does someone with a personality disorder — a significant, disabling, and dangerous condition — manage the stress of combat? Wouldn't a person with a serious mental problem drop out, or be identified and quickly discharged?

The answer, usually, is yes. People with paranoid, borderline or compulsive personality disorders, for instance, are hobbled by anxieties and delusional fears, experts say: two months of boot camp would typically be overwhelming for them. The low frequency of psychiatric breakdowns in Iraq — about 8 in 1,000 service members have been evacuated for psychiatric problems, fewer than in previous wars — suggests that few people with significant mental illness make it far in the service.

Yet the military does not perform full personality assessments on recruits unless there is some pressing reason to do so. Most anyone who has graduated from high school and avoided serious trouble with the law is qualified to enlist. And the psychological pressure recruits face during basic training is less intense than it once was, military experts say; the "shark attack" of screaming officers that used to greet fresh recruits has been tamed at some bases.

In this environment, people who have one diagnosis in particular — antisocial personality disorder — can often masquerade as bold, effective soldiers, psychiatrists argue. Antisocial behavior is characterized by reckless irresponsibility, habitual lying and an indifference to the suffering of others. In some reports Army officials have listed such a diagnosis as the reason for Mr. Green's discharge.

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"These are generally rough-and-ready types who tend to be trouble makers, who have no loyalty to groups or commanders," said Dr. Michael Stone, a professor of clinical psychiatry at Columbia University, who said he could not comment directly on the Army case. He added: "But they don't have to be pushed to act ruthlessly toward enemy combatants. It comes very naturally, which can be an admirable quality. And some small percentage of them are bound to slip through the cracks."

This is especially likely if they have a measure of charisma, of superficial charm, a glib talent for telling lies, criminologists say. These are hallmark traits of what some experts call psychopathy, a potent blend of antisocial instincts and grandiosity. From 25 percent to 30 percent of people who commit deliberate crimes of violence score highly on a test called the psychopathy checklist, said Robert Hare, an emeritus professor of psychology at the University of British Columbia in Vancouver, who devised the test.

Dr. Hare said he had not reviewed the Iraq case and could not comment on it specifically. "I can say that when you have a psychopathic offender, quite often he will manipulate others, he can be a puppet-master type," he said. "Others are attracted to his sense of certainty, his sense of power, to the fact that he can do things others have trouble doing."

A person with psychopathic tendencies may appear to others as clearheaded as an elite soldier when under fire, or when on the attack. But the internal psychological reality is much different, research suggests.

In several experiments conducted in 2001 and 2002, Dr. Andy Morgan of Yale University found that Special Operations soldiers, the Army's most elite fighters, had higher levels of stress hormones in their blood than regular infantrymen when under extreme stress during training. But they also had higher levels of another hormone that is thought to be a natural relaxant. In short, Dr. Morgan concluded, the elite soldiers were very much aware of the danger and moral implications of their actions but able keep their heads, and relax quickly when the danger passed.

By contrast, the psychopath functions well under pressure because he does not feel the moral tension at all.

At a time when recruiting has become increasingly difficult, the distinctions between the cool-headed, aware soldier and the psychopath may sometimes be overlooked. Would-be enlistees who have misdemeanors and even felonies on their records can and do obtain waivers to join the military if they're seen as fit, said Beth Asch, a specialist in military manpower at the RAND Corporation.

"These people do get looked at closely, but what it means is that even though there is a recruiting standard, that standard is not rock hard, and that's how we might get people in the service who have had mental problems," or black marks on their record, she said.

The number of atrocities against civilians is still small given the large number of troops deployed in the region. But as recent events make clear, just a few soldiers cause big trouble.

A version of this article appears in print on , on Page WK3 of the New York edition with the headline: When the Personality Disorder Wears Camouflage. Order Reprints|Today's Paper|Subscribe